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1. Reproductive strategies of two Neotropical killifish, Austrolebias vandenbergi and Neofundulus ornatipinnis (Cyprinodontiformes: Rivulidae) in the Bolivian Gran Chaco

Author

Christopher M. Schalk, Carmen G. Montaña, and Monika E. Libson

Subjects
bosque seco tropical, dimorfismo sexual, fecundidad, historia de vida, peces anuales, pozos efímeros, Biology (General), QH301-705.5
Abstract

The dry Chaco, a semiarid thorn forest, is experiencing some of the highest deforestation rates globally, coupled with the fact that small-bodied fish are at the highest risk of extinction, the killifish inhabiting this region may be some of the most threatened taxa. Yet, aspects of ecology and life history for Neotropical killifishes in the Bolivian Gran Chaco region are completely lacking, and basic life-history data is of critical importance for the design and implementation of conservation measures. Collections were conducted during the early (January 2011) and late (March-April 2011) rainy season using an area-based sampler and dip net surveys. Fish standard length and body depth were measured as well as the number of oocytes per size class, mean oocyte diameter per size class, and total fecundity for the females of each species. A total of 490 specimens of rivulids were captured; Austrolebias vandenbergi: 85 females, 105 males and 39 juveniles, and N. ornatipinnis: 62 females, 113 males, 86 juveniles. Sexual size dimorphism, absolute fecundity, oocyte developmental stages, oocyte diameter, and population sex ratios were determined for each species. Both species exhibited sexual size dimorphism. Male A. vandenbergi exhibited longer standard length (mean±SD; males: 27.07±3.89mm, females: 23.6±2.02mm) and body depth (males: 8.9±1.7mm, females: 7.2±1.1mm) as compared to females. Male N. ornatipinnis had a similar pattern for both standard length (males: 26.0±7.1mm, females: 19.1±5.83mm) and body depth (males: 5.6±1.9mm, females: 4.7±1.0mm). Austrolebias vandenbergi had fewer and smaller oocytes per female (47±31.6) than N. ornatipinnis (206±131.2). There was a positive relationship between fecundity and female body size in both species. The presence of multiple developmental stages of oocytes (immature, maturing, and mature) suggest that both species of rivulids exhibit fractional spawning, a reproductive strategy that enhances reproductive success in these extreme habitats. Neofundulus ornatipinnis exhibited a higher mean oocyte diameter for all three developmental stages (immature, maturing, and mature) as compared to A. vandenbergi. Austrolebias vandenbergi exhibited an equal adult sex ratio (males:females, 1:1), but there was a slight female biased ratio for N. ornatipinnis (males:females, 1:1.8). These results provide fundamental and valuable information for ensuring rivulid conservation in tropical regions, and also improve the knowledge on the biology and ecology of these poorly known species. To our knowledge, this study represents the first contribution on the reproductive biology of two Neotropical annual rivulid fishes (Austrolebias vandenbergi and Neofundulus ornatipinnis) inhabiting semi-permanent and ephemeral ponds in the Gran Chaco of Southeastern Bolivia.

Published
2014

2. P2-09-03: Breast Cancer Detection Using a Novel Functional Imaging Device Equipped with Multiparametric Computer Analysis

Author

D Izhaky, Miri Sklair-Levy, T Sella, C Maya, S Maira, M Rozin, E Libson, and A Tanir

Subjects
Functional imaging, Cancer Research, medicine.medical_specialty, Computer analysis, Breast cancer, Oncology, business.industry, Medicine, Radiology, business, medicine.disease
Abstract

Introduction: A novel prototype system performing functional three-dimensional (3D) infrared imaging (RUTH), coupled with multi-parametric computer analysis (MIRA), was evaluated for non-invasive breast cancer detection. The technique utilizes non-ionizing radiation and automatically provides risk assessment based on parameters derived from a clinically known training set. Materials and methods: Following IRB approval, prospective multi-center, two-armed blinded evaluation, was performed on 102 women, which included 43 patients with biopsy proven breast cancer and 59 women with a normal (BI-RADS 1) mammogram. RUTH imaging (Real Imaging Ltd, Israel) was acquired on a continuous temporal timeline for 5 minutes during which a cold-stress test was applied for one minute. Acquired data were analyzed using multiple computed algorithms (MIRA) which were combined to develop a master algorithm for risk assessment of breast cancer. Analysis was blinded to the clinical status. Results were displayed as risk assessment scale with 100 being suspicious for breast cancer and −100 inferring normal healthy breasts. Results Thirty-nine of 43 cancers (91.7%) were identified using this novel technology. The sensitivity and specificity of RUTH coupled with MIRA for detecting breast cancer were 90.7% and 67.8% respectively. The AUC defined by the ROC curve was 0.832. Twenty-seven of the 39 (70%) detected cancers were smaller than 20mm in size. Conclusions: This preliminary study shows adequate performance of the novel technology examined for detecting breast cancer. Performance is comparable to the reported performance of new adjunctive breast imaging technologies such as tomosynthesis and contrast-enhanced mammography, and superior to the published sensitivity of mammography. Our results warrant further evaluation of the RUTH and MIRA technologies in detecting and characterizing breast cancer. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-09-03.

Published
2011
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3. Reproductive strategies of two Neotropical killifish, Austrolebias vandenbergi and Neofundulus ornatipinnis (Cyprinodontiformes: Rivulidae) in the Bolivian Gran Chaco

Author

M. Schalk, Christopher, G. Montaña, Carmen, and E. Libson, Monika

Subjects
life history, peces anuales, fecundity, sexual dimorphism, tropical dry forest, annual fish, dimorfismo sexual, pozos efímeros, ephemeral ponds, fecundidad, historia de vida, bosque seco tropical
Abstract

The dry Chaco, a semiarid thorn forest, is experiencing some of the highest deforestation rates globally, coupled with the fact that small-bodied fish are at the highest risk of extinction, the killifish inhabiting this region may be some of the most threatened taxa. Yet, aspects of ecology and life history for Neotropical killifishes in the Bolivian Gran Chaco region are completely lacking, and basic life-history data is of critical importance for the design and implementation of conservation measures. Collections were conducted during the early (January 2011) and late (March-April 2011) rainy season using an area-based sampler and dip net surveys. Fish standard length and body depth were measured as well as the number of oocytes per size class, mean oocyte diameter per size class, and total fecundity for the females of each species. A total of 490 specimens of rivulids were captured; Austrolebias vandenbergi: 85 females, 105 males and 39 juveniles, and N. ornatipinnis: 62 females, 113 males, 86 juveniles. Sexual size dimorphism, absolute fecundity, oocyte developmental stages, oocyte diameter, and population sex ratios were determined for each species. Both species exhibited sexual size dimorphism. Male A. vandenbergi exhibited longer standard length (mean±SD; males: 27.07±3.89mm, females: 23.6±2.02mm) and body depth (males: 8.9±1.7mm, females: 7.2±1.1mm) as compared to females. Male N. ornatipinnis had a similar pattern for both standard length (males: 26.0±7.1mm, females: 19.1±5.83mm) and body depth (males: 5.6±1.9mm, females: 4.7±1.0mm). Austrolebias vandenbergi had fewer and smaller oocytes per female (47±31.6) than N. ornatipinnis (206±131.2). There was a positive relationship between fecundity and female body size in both species. The presence of multiple developmental stages of oocytes (immature, maturing, and mature) suggest that both species of rivulids exhibit fractional spawning, a reproductive strategy that enhances reproductive success in these extreme habitats. Neofundulus ornatipinnis exhibited a higher mean oocyte diameter for all three developmental stages (immature, maturing, and mature) as compared to A. vandenbergi. Austrolebias vandenbergi exhibited an equal adult sex ratio (males:females, 1:1), but there was a slight female biased ratio for N. ornatipinnis (males:females, 1:1.8). These results provide fundamental and valuable information for ensuring rivulid conservation in tropical regions, and also improve the knowledge on the biology and ecology of these poorly known species. To our knowledge, this study represents the first contribution on the reproductive biology of two Neotropical annual rivulid fishes (Austrolebias vandenbergi and Neofundulus ornatipinnis) inhabiting semi-permanent and ephemeral ponds in the Gran Chaco of Southeastern Bolivia. Información sobre la ecología e historia de vida de varias especies de rivulidos no ha sido estudiada, por lo tanto se analiza la biología reproductiva de dos especies neotropicales (Austrolebias vandenbergi y Neofundulus ornatipinnis) que habitan pozos semipermanentes y temporales en el Gran Chaco Boliviano. Las recolectas se realizaron al inicio y al final de la estación lluviosa. Dimorfismo sexual, fecundidad absoluta, diámetro de los ovocitos y proporción sexual fue determinada para cada especie de rivulido. Machos en las dos especies presentaron mayor tamaño de longitud estándar y altura del cuerpo cuando fue comparado con las hembras. Austrolebias vandenbergi tuvo menor fecundidad por hembra y huevos más pequeños que N. ornatipinnis, pero hembras en ambas especies presentaron una relación estrecha y positiva entre fecundidad y tamaño cuerpo. La presencia de varios estadios gonadales sugiere un desove fraccionado, lo cual es una estrategia reproductiva que promueve la viabilidad y sobrevivencia de estos peces en hábitats de extremas condiciones. La proporción sexual no varió entre machos y hembras de A. vandenbergi (1:1), pero en N. ornatipinnis la proporción sexual fue dominada por las hembras (1:1.8). Este estudio representa uno de los primeros que investiga aspectos de la biología reproductiva de A. vandenbergi y N. ornatipinnis, lo cual es importante para la conservación de rivulidos en regiones tropicales.

Published
2014

4. Fourth meeting of the European Neurological Society 25–29 June 1994 Barcelona, Spain

Author

H. Hattig, C. Delli Pizzi, M. C. Addonizio, Michelle Davis, A. R. Giovagnoli, L. Florensa, M. Roth, J. de Kruijk, Francisco Lacruz, Ph. Dewailly, A. Toygar, C. Avendano, P.P. De Deyn, J. F. Hurtevent, F. Lomeila, T. W. Wong, Gordon T. Plant, M. Bud, H. J. Willison, DH Miller, D. W. Langdon, R. Cioni, J. Servan, A. Kaygisiz, E. Racadot, D. B. Schens, E. Picciola, L. Falip, C. Bouchard, J. Jotova, A. Jorge-Santamaria, P. Misra, A. Dufour, C. P. Panagopoulos, A. Venneri, B. Sredni, B. Angelard, M. Janelidze, M. Carreno, J. Obenberger, J. Pouget, H. W. Moser, R. Kaufmann, J. A. Molina, D. Linden, A. Martin Urda, E. Uvestad, A. Krone, J. P. Cochin, J. Mallecourt, A. Cambon-Thomsen, K. Violleau, P. Osschmann, A. M. Durocher, E. Bussaglia, D. M. Danielle, H. Efendi, C. Van Broeckhoven, K. G. Jordan, W. Rautenberg, C. Iniguez, J. M. Delgado, Graham Watson, M. Lawden, Gareth J. Barker, K. Stiasny, James T. Becker, G. Campanella, E. Peghi, A. Poli, A. Haddad, T. Yamawaki, Giacomo P. Comi, S. Sotgiu, B. Ersmark, A. Pomes, M. Ziegler, P. Ferrante, P. Ruppi, H. KuÇukoglu, R. Bouton, U. K. Rinne, P. Vieregge, M. Dary, P. Giunti, Peter J. Goadsby, S. Jung, E. Secor, A. Steinberg, N. Vila, M. A. Hernandez, M. Cursi, A. Enqelhardt, A. Engelhardt, J. Veitch, F. Di Silverio, F. Arnaud, B. Neundörfer, R. Brucher, Dominique Caparros-Lefebvre, B. Meyer, Marianne Dieterich, M. H. Snidaro, R. Gomez, R. Cerbo, M. Ragno, J. M. Vance, S. Nemni, A. Caliskan, F. Barros, I. Velcheva, D. Ceballos-Baumann, V. Barak, A. Avila, N. Antonova, F. Resche, S. Pappata, L. Varela, S. R. Silveira Santos, A. Cammarota, L. Naccache, Y. Nara, E. Tournier-Lasserves, R. Mobner, T. Chase, A. Ensenyat, J. Ulrich, G. Giegerich, M. Rother, M. Revilla, N. Nitschke, K. Honczarenko, E. Basart Tarrats, J. Blin, B. Jacob, J. Santamaria, S. Knezevic, J. L. Castillo, M. Antem, J. Colomer, O. Busse, Didier Hannequin, S. Carrier, J. B. Ruidavets, C. Rozman, J. Bogoussslavsky, J. Pascual Calvet, E. Monros, J. M. Polo, M. Zucconl, Javier Muruzabal, R. R. Allen, R. Rivolta, K. Haugaard, A. Nespolo, K. Hoang-Xuang, G. Bussone, T. Avramidis, E. Corsini, Christiana Franke, T. Vinogradova, H. Boot, K. Vestergaard, G. H. Jansen, N. Argentino, M. Raltzig, W. Linssen, Mark B. Pepys, P. Roblot, L. Lauritzen, E. Fainardi, D. Morin, T. X. Arbizu Urdiain, J. Wollenhaupt, S. Bostantjopoulou, G. Pavesi, A. D. Forman, Giovanni Fabbrini, D. Jean, J. J. Archelos, M. I. Blanchs, M. Del Gobbo, Anna Carla Turconi, Ch. Derouesné, Elio Scarpini, A. Visbeck, P. Castejon, J. P. Renou, F. Mounier-Vehier, G. Potagas, Ch. Duyckaerts, A. Filla, R. Schneider, G. Ronen, K. Nagata, J. P. Vedel, A. Henneberg, G. van Melle, C. Baratti, H. Knott, M. C. Prevett, A. Bes, B. Metin, Jos V. Reempts, L. Martorell, Mefkure Eraksoy, H. O. Handwerker, D. S. Younger, O. Oktem, D. Frongillo, C. Soriano-Soriano, L. Niehaus, F. Zipp, A. Tartaro, S Newman, R. H. Browne, P. Davous, R. Sanchez, M. Muros, M. E. Kornhuber, A. Lavarone, M. Mohr, M. R. Garcia, S. Russell, H. Kellar-Wood, M. R. Tola, B. Ostermeyer, Ch. Tzekov, K. Sartor, E. B. Ringelstein, P. P. Gazzaniga, Paul Krack, H. Fidaner, H. Rico, T. Dbaiss, F. Alameda, E. Torchiana, L. Rumbach, I. Charques, J. M. Bogaard, C. D. Frith, L. J. Rappelle, R. Brenner, A. Joutel, K. Fuxe, G. HÄcker, M. J. Blaser, J. Valls-SolÇ, G. Ulm, M. Alberdi, A. Bock, F. W. Bertelsmann, U. Wieshmann, J. Visa, J. R. Lupski, D. D'Amico, L. M. P. Ramos, A. A. Vanderbark, R. Horn, M. Warmuth, Dietmar Kühne, Mark S. Palmer, C. Ehrenheim, E. Canga, S. Viola, O. Scarpino, P. Naldi, R. Almeida, A. A. Raymond, J. Gamez, Stephan Arnold, A. DiGiovanni, J. Dalmau, C. C. Chari, H. F. Beer, J. C. Koetsier, J. Iriarte, E. Yunis, J. Casadevall, E. Le Guern, E. Stenager, S. R. Benbadis, J. M. Warter, F. Burklin, I. Theodorou, L. Johannesen, G. A. Graveland, X. Leclerc, I. Vecchio, L. Ozelius, G. Nicoletti, R. K. Gherardi, E. Esperet, M. L. Delodovici, F. Cattin, F. Paiau, Giorgio Sacilotto, C. A. J. Broere, D. Chavdarov, J. P. Willmer, C. H. Hawkes, Th. Naegele, E. Ellie, E. Dartigues, M. J. Guardiola, S. Hesse, Z. Levic, Marco Rovaris, P. Saugeir-Veber, B. A. Yaqub, H. F. Durwen, R. Larumbe, J. Ballabrina, M. Sendtner, J. Röther, M. Horstink, C. Kluglein, M.P. Montesi, H. Apaydin, J. Montoya, E. Waubant, Ch. Verellen-Dunoulin, A. Nicolai, J. Lopez-Delval, R. Lemon, G. Cantinho, E. Granieri, A. Zeviani, Wolfgang H. Oertel, U. Ficola, V. Di Piero, V. Fragola, K. Sabev, M. V. Guitera, I. Turki, F. Bolgert, P. Ingrand, J. M. Gobernado, L. M. E. Grimaldi, S. Baybas, B. Eymard, Y. Rolland, Y. Robitaille, Ta. Pampols, P. J. Koehler, A. Carroacedo, J. Vilchez, S. Di Vittorio, I. R. Rise, T. Nagy, M. Kuffner, E. Palazzini, A. Ott, J. Pruim, T. X. Arbizu, E. Manetti, C. Cervera, S. Felber, G. Gursoy, J. Scholz, G. A. Buscaino, M. S. Chen, A. Pascual, J. Hazan, J. U. Gajda, J. G. Cea, G. Bottini, G. Damalik, F. Le Doze, G. Bonaldi, J. M. Hew, C. Messina, A. M. Kennedy, J. M. Carney, N. M. F. Murray, M. Parent, M. Koepp, V. Dimova, D. De Leo, K. Jellinger, G. Salemi, S. Mientus, M. L. Hansen, F. Mazzucchelli, J. Vieth, M. Mauri, E. Bartels, L. Johannsen, C. Humphreys, J. Emile, D. N. Landon, E. Kansu, R. Sanchez-Pernaute, Rsj Frackowiak, M. Gonzalez Torres, L. Oller, C. Machedo, J. Kother, M. Billiard, H. Durak, T. Schindler, A. Frank, A. Uncini, A. Sbriccoli, C. Farinas, D. W. Paty, N. Fast, A. T. Zangaladze, A. Kerkhofs, J. M. Pino Garcia, I. De la Fuente, B. Marini, L. Gomez, I. Rubio, Alessandra Bardoni, C. Brodie, P. Acin, U. Sliwka, S. A. Hawkins, S. Tardieu, F. Vitullo, J. M. Pereira Monteino, R. Gagliardi, T. Jezewski, A. Cano, T. Lempert, F. Abad Alegria, G. Rotondo, D. Ince, C. Martinez Parra, Y. Huang, H. Luders, Y. Steinvil, F. G. A. Van Der Meche, R. Bianchi, A. Sanchez, T. Sevilla, J. M. Ketelslegers, A. Domzal-Stryga, M. Pandolfo, M. O. Josse, K. W. Neff, I. Blanco, G. W. Bruyn, O. W. Witte, J. L. Thibault, G. Andersen, J. Pariset, A. Marcone, R. J. M. Lane, A. Hofman, M. Verin, T. Matilla, P. Bedoucha, J. Roche, M. Lai, M. Collard, A. Ugarte, F. Gallecho, D. Silbersweig, C. Kennard, J. P. Azulay, T. W. Ho, P. L. I. Dellemijn, R. Girardello, F. Baas, B. Voss, F. Rozenberg, E. M. Brocker, V. Stanev, A. A. J. Soeterboek, A. Marra, A. Rey, E. Ertem, M. Sawradewicz-Rybak, J. De Keyser, P. Cavallari, F. Proust, Y. Chevalier, H. C. Hansen, D. Leys, C. A. Davie, K. Hoang-Xuan, C. Bairati, H. van Crevel, Thomas T. Warner, B. Bompais, A. Dobbeleir, T Campbell, C. Macko, C. J. M. Klijn, M. Dussallant, T. P. Berlit, W. Rozenbaum, M. J. van den Bent, W. A. Rocca, M. Muller, H. Hundemer, U. Zifko, M. Campera, F. Drislane, D. Ranoux, T. M. Kloss, Anil Kumar, I. Ruolt, C. Bargnani, B. Marescau, N. A. Losseff, S. Notermans, B. Kint, E. T. Burke, C. Aykut, J. Matias Guiu, P. Maquet, T. Drogendijk, M. Leone, K. von Ammon, M. Pepeliarska, C. Prados, L. DiGiamberardino, T. Logtenberg, G. Lenoir, I. Castaldo, Damhaut, M. Radionova, G. Sirabian, R. Navon, Giovanni Antonini, K. Al Moutaery, E. Chamas, R. Schönhuber, M. Giannini, B. Debilly, I. Labatut, H. Henon, J. A. Egido, M. Baudrimont, J. N. Lorenzo, J. E. C. Bromberg, R. Antonacci, J. J. Vilchez, T. Moulin, B. Rautenstrauss, Giovanni Meola, J. Noth, S Mammi, P. Laforet, F. Lopez, C. Gehring, S. Bort, G. Rancurel, D. Decamps, S. Kostadinova, Y. Shapira, B. Neundoerfer, D. Chavrot, M. Solimena, J. P. Salier, W. Deberdt, R. Hoff-Jörgensen, A. Messina, S. Meairs, G. Rosoklija, E. Nelis, I. Bertran, C. Ertekin, J. Lohmeyer, Mitermayer Galvao dos Reis, L. Calo, E. Maccagnano, A. P. Hays, J. Verlooy, M. G. Forno, T. Blanco, L. Bail, Gabriella Silvestri, J. Montero, F. Bertrand, R. T. Ghnassia, C. Besses, T. Sereghy, F. Shalit, G. Bogliun, S. Braghi, St. Baykouchev, C. Franke, A. Lasa, L. C. Archard, J. Kriebel, S. Shaunak, M. Nocito, Alexander Tsiskaridze, E. Manfredini, T. Seigal, David G. Gadian, M. Barlas, J. D. Degos, C. Seeber, J. Caemert, J. L. Mas, R. B. Pepinsky, M. G. D'Angelo, N. Baumann, S. Yorifuji, H. P. Endtz, M. A. Cassatella, R. A. C. Hughes, V. Golzi, A. Bittencourt, A. Ferreira, M. Sanson, C. Alper, M. Vermeulen, M. A. A. van Walderveen, E. Alexiou, C. H. Lucas, M. Fiorelli, Y. N. Debbink, R. Gil, S. Congia, T. Banerjee, J. M. Bouchard, A. N. Pinto, A. Ceballos-Baumann, G. Grollier, P. I. M. Schmitz, M. D. Catata, N. Lahat, N. S. Rao, P. Papathanasopoulos, J. Valls-Solé, D. Claus, G. Schroter, A. Castro, C. Videbaek, R. Martinez Dreke, A. D. Platts, M. Hermesl, A. C. PeÇanha-Martins, M. Cardoso Silva, P. Masnou, M. J. A. Tanner, Ch. Confavreux, B. Mishu, H. Rasmussen, L. Valenciano, Carlo Pozzilli, S. W. Li, V. Salzman, Y. Vashtang, Massimo Franceschi, M. Severo, G. Deuschl, S. Setien, G. Mariani, A. Protti, J. Castillo, M. J. B. Taphoorn, M. Frontali, I. Milonas, D. Decoq, J. A. Navarro, S. Castellvi-Pel, C. Ertikin, M. Urtasun, Y. Lajat, B. E. Kendall, E. Verdu, B. Gueguen, E. Boisen, R. Couderc, A Danek, JM Stevens, F. Nicoli, L. Feltri, M. L. Vazquez-Andre, J. A. Morgan-Hughes, L. D'Angelo, F. Y. Liew, L. F. Pascual, J. Patrignani Ochoa, Vittorio Martinelli, J. Cophignon, L. Zhang, S. Martin, J. F. Meder, H. C. Buschmann, L. Bertin, J. van Gijn, A. Barreiro, A. Cools, C. Leon, A. Berod, E. A. Anllo, E. Zanette, L. Petrov, R. Barona, B. Gallicchio, P. J. Cozzone, N. Diederich, G. Cancel, L. Schelosky, P. Orizaola, K. Yulug, S. Ozer, Valeria A. Sansone, B. Guiraud-Chaumeil, K. Voigt, P. Labauge, M. Eoli, J. Zhu, J. Aguirre, M. Ferrarini, B. Zyluk, E. Planas, A. Cadilha, C. Tortorella, H. Bismuth, C. E. Counsell, A. Laun, A. Ferlini, Rio J. Montalban, N. Biary, L. Becker, M. Fardeau, M. Poloni, V. M. S. de Bruin, C. Fornada, J. Barros, E. Ganzmann, E. Touze, D. Wallach, J. Peila, H. Fujimura, M. T. Iba-Zizen, G. Macchi, C. Villoslada, R. Gouider, Ph. Rondepierre, P. Grummich, P. Chiodi, C. Conte, M. Michels, P. Annunziata, G. Semana, C. Sommer, J. Vajsar, D. Zekin, J. Kulisevsky, David G. Munoz, B. Jacotot, M. Magoni, A. Luxen, T. Garcia-Silva, S. Di Cesare, Christophe Tzourio, M. Gomori, I. Picomell, L. Santoro, F. Villa, Giovanni Pennisi, T. Ribalta, J. M. Molto, L. Marzorati, P. Loiseau, F. Gemignani, A. Gironell, J. Wissel, A. Prusinski, F. Cailloux, P. Villanueva-Hemandez, P. Cozzone, T. Del Ser, J. Sans-Sabrafen, M. Zappia, P. W. A. Willems, G. Tchernia, D. Gardeur, R. Bauer, F. Palomo, H. Metz, S. Lamoureux, C. Chastang, I. Reinhard, A. Goldfarb, S. Harder, Jordi Río, C. Ozkara, E. Tekinsoy, P. Vontobell, J. De Recondo, M. Rabasa, L. Lacomblez, F. Boon, Dgt Thomas, V. Palma, Renato Mantegazza, A. Dervis, M. Nueckel, B. YalÇinerner, I. Duran, G. Dalla Volta, A. Zubimendi, J. Pinheiro, A. Marbini, Xavier Montalban, H. Wekerle, X. Pereira Monteino, F. Crespo, F. Koskas, N. Battistini, C. Ruiz, H. Offner, J. de Pommery, P. Kanovsky, J. Y. Barnett, J. Pardo, G. Tomei, R. Rene, H. M. Lokhorst, P. Thajeb, H. Bilgin, D. McGehee, R. Fahsold, L. Morgante, Katie Sidle, C. Delwaide, M. N. 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Riva, M. H. Mahagne, M. Ozturk, Ve. Drory, N. Konic, C. Jungreis, A. Pou Serradell, J. L. Gauvrit, G. J. Chelune, S. Hermandez, T. Dingus, L. Hewer, Ch. Koch, M. N. Metz-Lutz, G. Parlato, M. Sinaki, Charles Pierrot-Deseilligny, H. C. Diener, J. Broeckx, J. Weill-Fulazza, M. L. Villar, M. Rizzo, O. Ganslandt, C. Duran, N. A. Fletcher, G. Di Giovacchino, Susan T. Iannaccone, C. Kolig, N. Fabre, H. A. Crockard, Rita Bella, M. Tazir, E. Papagiannuli, K. Overgaard, Emma Ciafaloni, I. Lorenzetti, F. Viader, P. A. H. Millac, I. Montiel, L. H. Visser, M. Palomar, P. L. Murgia, H. Pedersen, Rafael Blesa, S. Seddigh, W. O. Renier, I. Lemahieu, H. M. L. Jansen, L. Rosin, J. Galofre, K. Mattos, M. Pondal, G. M. Hadjigeorgiou, D. Francis, L. Cantin, D. Stegeman, M. Rango, A. B. M. F. Karim, S. Schraff, B. Castellotti, I. Iriarte, E. Laborde, T. J. Tjan, R. Mutani, D. Toni, B. Bergaasco, J. G. Young, C. Klotzsch, A. Zincone, X. Ducrocq, M. Uchuya, O. J. Kolar, A. Quattrone, T. Bauermann, Nereo Bresolin, J. Vallée, B. C. Jacobs, A. Campos, Werner Poewe, J. A. Villanueva, A. W. Kornhuber, A. Malafosse, E. Diez-Tejedor, G. Jungreia, M. J. A. Puchner, A. Komiyama, O. Saribas, V. Volpini, L. Geremia, S. Bressi, A. Nibbio, Timothy E. Bates, T. z. Tzonev, E. Ideman, G. A. Damlacik, G. Martino, G. Crepaldi, T. Martino, Kjell Någren, E. Idiman, D. Samuel, J. M. Perez Trullen, Y. van der Graaf, J. O. Thorell, M. J. M. Dupuis, E. Sieber, R. D'Alessandro, C. Cazzaniga, J. Faiss, A. Tanguy, A. Schick, I. Hoksergen, A. Cardozo, R. Shakarishvili, G. K. Wennlng, J. L. Marti-Vilalta, J. Weissenbach, I. L. Simone, Amalia C. Bruni, Darius J. Adams, C. Weiller, A. Pietrangeli, F. Croria, C. Vigo-Pelfrey, Patricia Limousin, A. Ducros, G. Conti, O. Lindvall, E. Richter, M. Zuffi, A. Nappo, T. Riise, J. Wijdenes, M. J. Fernandez, J. Rosell, P. Vermersh, S. Servidei, M. S. C. Verdugo, F. Gouttiere, W. Solbach, M. Malbezin, I. S. Watanabe, A. Tumac, W. I. McDonald, D. A. Butterfield, P. P. Costa, F. deRino, F. Bamonti, J. M. Cesar, C. H. Lahoz, I. Mosely, M. Starck, M. H. Lemaitre, K. M. Stephan, S. Tex, R. Bokonjic, I. Mollee, L. Pastena, M. Gutierrez, F. Boiler, M. C. Martinez-Para, M. Velicogna, O. Obuz, A. Grinspan, M. Guarino, L. M. Cartier, E. Ruiz, D. Gambi, S. Messina, M. Villa, Michael G. Hanna, J. Valk, Leone Pascual, M. Clanet, Z. Argov, B. Ryniewicz, E. Magni, B. Berlanga, K. S. Wong, C. Gellera, C. Prevost, F. Gonzalez-Huix, R. Petraroli, J. E. G. Benedikz, I. Kojder, C. Bommelaer, L. Perusse, M. R. Bangioanni, Guy M. McKhann, A. Molina, C. Fresquet, E. Sindern, Florence Pasquier, M. J. Rosas, M. Altieri, O. Simoncini, M. Koutroumanidis, C. A. F. Tulleken, M. Dary-Auriol, S. Oueslati, H. Kruyer, I. Nishisho, C. R. Horning, A. Vital, G. V. Czettritz, J. Ph. Neau, B. Mihout, A. Ameri, M. Francis, S. Quasthoff, D. Taussig, S. Blunt, P. Valentin, C. Y. Gao, O. Heinzlef, H. d'Allens, C. Coudero, M. Erfas, G. Borghero, P. J. Modrego Pardo, M. C. Patrosso, N. L. Gershfeld, P. A. J. M. Boon, O. Sabouraud, M. Lara, J. Svennevig, G. L. Lenzi, A. Barrio, H. Villaroya, JosÇ M. Manubens, O. Boespflug-Tanguy, M. Carreras, D. A. Costiga, J. P. Breux, S. Lynn, C. Oliveras Ley, A. G. Herbaut, J. Nos, C. Tornali, Y. A. Hekster, J. L. Chopard, J. M. Manubens, P. Chemouilli, A. Jovicic, F. Dworzak, S. Smirne, S. E. Soudain, B. Gallano, D. Lubach, G. Masullo, G. Izquierdo, A. Pascual Leone Pascual, A. Sessa, V. Freitas, O. Crambes, L. Ouss, G. W. Van Dijk, P. Marchettini, P. Confalonieri, M. Donaghy, A. Munnich, M. Corbo, and M. E. L. van der Burg

Subjects
Neurology, business.industry, Media studies, Library science, Medicine, Neurology (clinical), business
Published
1994
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5. Hodgkin's disease of the gastrointestinal tract

Author

E. Mapp, Abraham H. Dachman, and E. Libson

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Adolescent, Stage iv disease, Disease, Gastroenterology, Descending colon, Diagnosis, Differential, Stomach Neoplasms, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Gastrointestinal Neoplasms, Neoplasm Staging, Hodgkin s, Gastrointestinal tract, Jejunal Neoplasms, business.industry, Transverse colon, General Medicine, Middle Aged, Hodgkin Disease, Curvatures of the stomach, medicine.anatomical_structure, Colonic Neoplasms, Female, Differential diagnosis, Tomography, X-Ray Computed, business
Abstract

Hodgkin's disease (HD) is rarely considered in the differential diagnosis of gastrointestinal (GI) disorders. We report eight cases of GI HD. The patients, ages 16-64, all with stage IV disease of varied histologic subtypes and GI symptoms including pain, upper or lower GI bleeding and/or obstruction. There was diffuse gastric fold thickening in one case, a large submucosal mass along the proximal greater curvature in another case, and a large ulcerating mass along the lesser curvature in the third case. Two cases of jejunal disease manifested as either a short or long segment of luminal narrowing with prominent mucosal nodularity. Another case exhibited a short area of complete mucosal destruction, irregular cavitation and intraluminal filling defect. In one additional case there was diffuse jejunal nodularity. Colonic involvement (two cases) presented as a solitary polypoid mass in transverse colon in one patient and severe narrowing of the descending colon with adjacent mesenteric mass on CT in another. We conclude that although rare in Hodgkin's disease, GI involvement should be considered, particularly in patients with stage IV disease.

Published
1994
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6. Legionella feeleii pneumonia and pericarditis

Author

E. Libson, D. Raveh, Arie Ben-Yehuda, I. Boldur, Rifaat Safadi, and S. Sviri

Subjects
Male, Microbiology (medical), medicine.medical_specialty, Pericarditis, Internal medicine, Pneumonia, Bacterial, medicine, Humans, Pericardial disease, Antibacterial agent, Legionellosis, biology, Legionella feeleii, business.industry, Respiratory disease, Middle Aged, medicine.disease, biology.organism_classification, respiratory tract diseases, Pneumonia, Infectious Diseases, Bacterial etiology, Lung disease, Immunology, business
Abstract

Legionella feeleii pneumonia has been described in seven cases, three of them being immunocompromised. We describe a case of L. feeleii pneumonia and pericarditis in a healthy man. Epidemiological survey was not conclusive. To the best of our knowledge, there have been no previous descriptions of pericarditis caused by this organism.

Published
1997
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7. Clinical utility of computed tomography-guided core needle biopsy in the diagnostic re-evaluation of patients with lymphoproliferative disorders and suspected disease progression

Author

Ora Paltiel, G. Amir, N. Goldschmidt, A. Bloom, and E. Libson

Subjects
Adult, Male, medicine.medical_specialty, Open biopsy, Adolescent, Chronic lymphocytic leukemia, Lymphoproliferative disorders, Disease, Biopsy, medicine, Humans, Pathological, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Biopsy, Needle, Retrospective cohort study, Hematology, Middle Aged, medicine.disease, Lymphoproliferative Disorders, Lymphoma, Surgery, Oncology, Disease Progression, Female, Radiology, business, Tomography, X-Ray Computed
Abstract

Background Histological transformation is a common clinical event in patients with lymphoproliferative diseases, often requiring a modification in therapy. Minimally invasive biopsy techniques have been used for initial diagnosis of these disorders but their role has not been systematically evaluated in disease progression. The purpose of this study was to evaluate the yield of computed tomography (CT)-guided core needle biopsy in patients with lymphoproliferative disorders and suspected disease progression. Patients and methods We performed a retrospective analysis of the records of patients with known lymphoproliferative disorders who underwent CT-guided core needle biopsy during the course of their disease, between 1990 and 2002. Results A total of 130 patients with lymphoproliferative disorders (91 patients with non-Hodgkin’s lymphoma, 21 with Hodgkin’s disease, 10 with chronic lymphocytic leukemia, six with combined malignancies and two with Castleman’s disease) underwent CT-guided core needle biopsy 4.7 ± 5.1 (standard deviation) (range 0–40) years after initial diagnosis. The procedure was diagnostic in 98 cases (75.4%). In 22 patients (17%) a subsequent open biopsy was performed, and in 10 (7.6%) the final diagnosis remained unconfirmed. Histological transformation was found in 20 cases (15.4%), of which 19 were suspected clinically. A new diagnosis (malignant and non-malignant) was apparent in 18 cases (13.9%) and relapsed or ongoing evidence of the original disease was found in 82 (63%). Conclusions CT-guided core needle biopsy is a reliable procedure in patients with suspected histological transformation of lymphoproliferative disorders, and should be used as the initial tool for pathological re-evaluation.

Published
2003

8. Is chest CT sufficient for follow-up of primary mediastinal B-cell lymphoma in remission?

Author

S. Apter, E. Libson, D. Ben-Yehuda, E. Nof, I. Boger-Megiddo, and J. A. Spencer

Subjects
Thorax, Adult, Male, medicine.medical_specialty, Lymphoma, B-Cell, Adolescent, Scintigraphy, Mediastinal Neoplasms, Sensitivity and Specificity, medicine, Humans, Radiology, Nuclear Medicine and imaging, Pelvis, Retrospective Studies, medicine.diagnostic_test, business.industry, Remission Induction, Mediastinum, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Lymphoma, medicine.anatomical_structure, Abdomen, Female, Radiology, Primary mediastinal B-cell lymphoma, Neoplasm Recurrence, Local, business, Tomography, X-Ray Computed, Follow-Up Studies
Abstract

We aimed to evaluate whether chest CT alone is sufficient for follow-up assessment of patients with primary mediastinal B-cell lymphoma that is in remission.A retrospective review of medical records and CT examinations of patients who received a diagnosis of primary mediastinal B-cell lymphoma between January 1989 and January 2000 was performed. The first-year follow-up comprised examinations at 3-month intervals of the neck, chest, abdomen, and pelvis, with the examination modality alternating between CT and gallium scintigraphy. Patients who achieved complete remission underwent the same CT protocol twice the following year and then once a year during sequential follow-up.Fifty-three patients with primary mediastinal B-cell lymphoma at presentation--31 females and 22 males, ranging in age from 17 to 61 years (average age at diagnosis, 34 years)--were studied. The follow-up time ranged from 6 to 143 months (average follow-up time, 42.4 months). Although 11 of the patients had only a partial remission, 42 patients (79%) achieved complete remission, with one patient lost to follow-up and thus excluded from study. Recurrence was diagnosed in six of these 42 patients. All six had mediastinal recurrence with additional involvement of the lungs, chest wall, pericardium, and pleura. One patient also had bone marrow involvement at recurrence.Recurrence of primary mediastinal B-cell lymphoma in patients who achieve complete remission appears to be confined to the chest. Consequently, chest CT alone is sufficient for routine follow-up of these patients.

Published
2002

9. [Transarterial oil chemoembolization for hepatocellular carcinoma, in 100 cases]

Author

I, Levy, A, Verstandig, T, Sasson, D, Wolf, I, Krichon, E, Libson, P, Levensart, O, Papo, O, Yurim, A, Id, and D, Shouval

Subjects
Survival Rate, Carcinoma, Hepatocellular, Liver Neoplasms, Hepatectomy, Humans, Chemoembolization, Therapeutic, Middle Aged, Combined Modality Therapy, Aged, Neoplasm Staging, Retrospective Studies
Abstract

Hepatocellular carcinoma (HCC) is a common malignancy with a grave prognosis. Most patients have both the malignant tumor as well as hepatic cirrhosis. Liver transplantation or hepatectomy are considered the only curative procedures, but can be applied in fewer than 10% of patients. In recent decades the most common treatments of HCC are transarterial chemoembolization with oil (TOCE) and percutaneous ethanol injection (PEI). We summarize our retrospective study of 100 patients (mean age 64 +/- 3) treated by TOCE. In 271 procedures between 1989-1998, in 16 patients hepatectomy was combined with TOCE and in 8 PEI was combined with TOCE, while the rest were treated by TOCE alone. Tumor mass was reduced in 36% of those treated by TOCE (tumor volume reduced 24-75%). Alpha-feto protein (AFP) was reduced 25-90% in 20/32 of those with elevated AFP levels. Median survival for the 100 in the entire group was 19 months (10.9 months in those with conservative treatment). Median survival in the 57 in Okuda stage 1 and the 43 in stages 2 or 3 was 30.1 months and 10.9 months, respectively (p0.0001). Of the 57 in stage 1, 16 underwent hepatectomy in addition to TOCE and 41 were treated only by TOCE (median survival 15 and 26 months, respectively, p not significant). Comparing Okuda 1 patients treated by TOCE only with the natural history of the disease and historical controls (Okuda 1 patients treated conservatively in 1984) median survival was 26 and 10 months respectively (p0.001). The side effects of TOCE were relatively mild. There was 1 fatality (3 days after treatment), and quality of life was maintained. Despite progress in the treatment of HCC by TOCE, PEI, and liver transplantation, long-term survival has remained unsatisfactory.

Published
2000

10. Estrategias reproductivas de dos especies de rivulidos Neotropicales Austrolebias vandenbergi y Neofundulus ornatipinnis (Cyprinodontiformes: Rivulidae) en el Gran Chaco Boliviano

Author

Christopher M. Schalk, Carmen G. Montaña, and Monika E. Libson

Subjects
biology, Ecology, Killifish, Life history, Cyprinodontiformes, General Agricultural and Biological Sciences, biology.organism_classification, Rivulidae, Austrolebias vandenbergi, Humanities, Neofundulus
Abstract

Informacion sobre la ecologia e historia de vida de varias especies de rivulidos no ha sido estudiada, por lo tanto se analiza la biologia reproductiva de dos especies neotropicales (Austrolebias vandenbergi y Neofundulus ornatipinnis) que habitan pozos semipermanentes y temporales en el Gran Chaco Boliviano. Las recolectas se realizaron al inicio y al final de la estacion lluviosa. Dimorfismo sexual, fecundidad absoluta, diametro de los ovocitos y proporcion sexual fue determinada para cada especie de rivulido. Machos en las dos especies presentaron mayor tamano de longitud estandar y altura del cuerpo cuando fue comparado con las hembras. Austrolebias vandenbergi tuvo menor fecundidad por hembra y huevos mas pequenos que N. ornatipinnis, pero hembras en ambas especies presentaron una relacion estrecha y positiva entre fecundidad y tamano cuerpo. La presencia de varios estadios gonadales sugiere un desove fraccionado, lo cual es una estrategia reproductiva que promueve la viabilidad y sobrevivencia de estos peces en habitats de extremas condiciones. La proporcion sexual no vario entre machos y hembras de A. vandenbergi (1:1), pero en N. ornatipinnis la proporcion sexual fue dominada por las hembras (1:1.8). Este estudio representa uno de los primeros que investiga aspectos de la biologia reproductiva de A. vandenbergi y N. ornatipinnis, lo cual es importante para la conservacion de rivulidos en regiones tropicales.

Published
2014
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11. CT-guided biopsy of peripheral lung lesions associated with BOOP

Author

Y S, Haviv, R, Breuer, S, Sviri, E, Libson, and R, Safadi

Subjects
Adult, Male, Pleural Effusion, Hydrocortisone, Cryptogenic Organizing Pneumonia, Biopsy, Humans, Radiography, Thoracic, Tomography, X-Ray Computed, Glucocorticoids, Lung, Anti-Bacterial Agents
Abstract

Diagnosis of Bronchitis Obliterans with Organizing Pneumonia (BOOP), has been carried out thus far by open lung biopsy, or by transbronchial biopsy. We report a patient who presented with fever, cough and dyspnea. A transthoracic CT-guided biopsy of a peripheral lesion resulted in the diagnosis of BOOP. The histological findings were also confirmed by a transbronchial biopsy. It is suggested that transthoracic CT-guided biopsy should be considered for the evaluation of peripheral lung lesion compatible with BOOP.

Published
1997

12. Recent Collection of a False Spike (Quadrula mitchelli) in the San Saba River, Texas, with Comments on Habitat Use

Author

Eric T. Tsakiris, Monika E. Libson, Bryan Sowards, and Charles R. Randklev

Subjects
education.field_of_study, Extinction, Geography, Habitat, biology, Range (biology), Ecology, Population, Endangered species, Life history, biology.organism_classification, education, Quadrula
Abstract

Similar to other rare and endemic freshwater mussel species in Texas, the distribution and life history of the False Spike, Quadrula mitchelli, is poorly understood. Few recent locality records suggest that Q. mitchelli has been extirpated from much of its range and is declining in numbers at an alarming rate, which has led to it being petitioned for listing under the Endangered Species Act. We present our findings of the discovery of one live individual collected on the San Saba River, TX and provide information regarding the species’ habitat use. The discovery represents the second known population in Texas and the only record of a live individual from the San Saba River. Knowledge of habitat use may help identify populations in other streams and allow managers to develop recovery plans for Q. mitchelli. However, given the rarity of this species, Q. mitchelli potentially faces extinction unless prompt conservation action is taken by state and federal agencies.

Published
2013
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13. Gastric leiomyosarcoma (Review)

Author

I Roisman, R Bloom, E. Libson, E Okon, and A. L. Durst

Subjects
Oncology, Cancer Research, medicine.medical_specialty, business.industry, Stomach, Cancer, medicine.disease, medicine.anatomical_structure, Gastric Leiomyosarcoma, Internal medicine, medicine, Radiology, Presentation (obstetrics), business, Pathological
Abstract

Gastric leiomyosarcoma is a rare malignant tumor of the stomach which has seldom been described in the literature. Three patients, aged 47, 55, and 72 at time of presentation, were treated by the authors between 1985 and 1989. Clinical and pathological findings, treatment and outcome are discussed. A literature review is provided to establish a correlation between clinical and pathological findings, surgical and oncological treatment, and rate of survival.

Published
1996
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14. Disseminated Nocardia transvalensis infection resembling pulmonary infarction in a liver transplant recipient

Author

M. Shapiro, E. Libson, M. Weinberger, L. Schreiber, T. Sacks, Yaron Ilan, Ran Tur-Kaspa, and Ahmed Eid

Subjects
Microbiology (medical), Male, Pathology, medicine.medical_specialty, medicine.medical_treatment, Nocardia Infections, Bacteremia, Liver transplantation, Diagnosis, Differential, Immunocompromised Host, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, Humans, Lung, Pulmonary Infarction, business.industry, Nocardiosis, Respiratory disease, General Medicine, Middle Aged, medicine.disease, Pulmonary embolism, Liver Transplantation, Infectious Diseases, medicine.anatomical_structure, Actinomycosis, business, Pulmonary Embolism
Abstract

Infections due to Nocardia transvalensis are extremely rare: only four disseminated infections with this pathogen have been reported, three of which ended fatally. This is the first report of a liver transplant recipient with Nocardia transvalensis infection. The patient had disseminated infection with pulmonary involvement, which presented as pulmonary infarction. Despite a ten-day delay in the administration of correct therapy, he responded rapidly to trimethoprim-sulfamethoxazole. The pitfalls of differentiating nocardial infection from pulmonary thromboembolism in solid organ transplant recipients and the diagnostic considerations unique to liver transplant recipients are discussed.

Published
1995

15. Breast metastases to bones of the extremities: simultaneous involvement of all four limbs

Author

R.A. Bloom, G. Freilick, A. Sulkes, and E. Libson

Subjects
medicine.medical_specialty, Leg, business.industry, Foot, Carcinoma, Bone Neoplasms, Breast Neoplasms, Middle Aged, Hand, Surgery, Oncology, Bone tumours, medicine, Arm, Humans, Radiology, Nuclear Medicine and imaging, Female, Breast carcinoma, business, Foot (unit)
Abstract

Metastases to bones of the hands and feet are unusual, and simultaneous metastases to the bones of more than one extremity in a given patient is an extremely rare occurrence with only five previous case reports. In each of these cases the bones of two extremities were affected. A case is presented where the bones of both hands and both feet exhibited bone metastases. A second case with foot bone metastases is recorded. In both cases the primary tumour was a breast carcinoma. Theories of causation of such metastases are discussed.

Published
1992

16. Hodgkin's Lymphoma of the Urinary Bladder

Author

E. Libson, Izidore S. Lossos, and J. Sosna

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Urinary bladder, business.industry, General Medicine, Hodgkin's lymphoma, medicine.disease, Hodgkin Disease, Gastroenterology, Lymphoma, medicine.anatomical_structure, Urinary Bladder Neoplasms, Recurrence, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Tomography, X-Ray Computed, business, Follow-Up Studies
Published
2000
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17. Localized primary sclerosing cholangitis mimicking a cholecystectomy stricture relieved by an endoprosthesis

Author

Ran Oren, E. Goldin, N. Harats, D. Shouval, and E. Libson

Subjects
Adult, medicine.medical_specialty, medicine.medical_treatment, Cholangitis, Sclerosing, Hepatic Duct, Common, Liver transplantation, Gastroenterology, Primary sclerosing cholangitis, Diagnosis, Differential, Cholangiography, Postoperative Complications, Internal medicine, medicine, Humans, Cholecystectomy, Cholangiopancreatography, Endoscopic Retrograde, medicine.diagnostic_test, business.industry, General Medicine, Prostheses and Implants, Cholestasis, Extrahepatic, medicine.disease, Endoscopy, Endoscopic retrograde cholangiography, Obstructive jaundice, Female, Radiology, Differential diagnosis, business, Research Article
Abstract

Summary Primary sclerosing cholangitis presenting as a localized stricture affecting a segment of the extrahepatic biliary tree is rarely found. We describe the case of a 39 year old woman with obstructive jaundice, in whom this diagnosis was proven by endoscopic retrograde cholangiography. An endoprosthesis was endoscopically introduced through the stenotic area which led to a dramatic improvement enabling a successful liver transplantation after 2 years.

Published
1991

18. Gastrointestinal manifestations in Castleman's disease

Author

D, Wengrower, E, Libson, E, Okon, and E, Goldin

Subjects
Adult, Male, Gastrointestinal Diseases, Castleman Disease, Humans, Female, Middle Aged, Aged
Abstract

Castleman's disease is a relatively rare disorder of lymphoid tissue. The disease is considered benign in its localized form, but severe in the multicentric type. Gastrointestinal manifestations were occasionally described. We herein report four patients with histologically proved Castleman's disease in whom various and different clinical and pathological manifestations were found in the gastrointestinal tract, correlated with the primary disease. We believe that the digestive tract may be secondarily involved in Castleman's disease and, in some cases, gives the first manifestation of the disease.

Published
1990

19. Treatment of fistulas of the biliary tract by endoscopic insertion of endoprostheses

Author

E, Goldin, E, Katz, D, Wengrower, Y, Kluger, L, Haskel, E, Shiloni, and E, Libson

Subjects
Adult, Cholangiopancreatography, Endoscopic Retrograde, Male, Biliary Fistula, Time Factors, Adolescent, Guinea Pigs, Prostheses and Implants, Middle Aged, Wounds, Nonpenetrating, Skin Diseases, Postoperative Complications, Evaluation Studies as Topic, Animals, Drainage, Humans, Female, Stents, Duodenoscopy
Abstract

Five patients with fistulas of the biliary tract are reported; three had fistulas caused by operative injury and two, by accidental blunt abdominal trauma. All patients were treated successfully by endoscopic transpapillary insertion of biliary endoprostheses. The endoprostheses were removed after four to 17 weeks in all patients, and no evidence of biliary leakage was revealed by repeat cholangiograms and other clinical follow-up study. This effective, simple and safe method allows the fistula to heal and is a good alternative to surgical treatment.

Published
1990

20. Severe acute pancreatitis as the presenting symptom of primary sclerosing cholangitis: treatment by endoscopic insertion of a biliary stent

Author

E, Goldin, E, Libson, D, Wengrower, S, Antal, Z, Kovacs, and D, Rachmilewitz

Subjects
Cholangiopancreatography, Endoscopic Retrograde, Male, Pancreatitis, Acute Disease, Cholangitis, Sclerosing, Humans, Stents, Middle Aged
Abstract

Primary sclerosing cholangitis is a chronic, fibrosing, inflammatory condition of unknown origin of extra and intrahepatic bile ducts. Recurrent cholangitis and jaundice are the most frequent clinical manifestation in symptomatic patients. We report a patient with primary sclerosing cholangitis presented with recurrent attacks of acute pancreatitis. Such a combination was not reported till now in the literature. The acute pancreatitis was probably due to reflux of bile and sludge into the pancreatic duct due to stricture of the distal part of a common bile and pancreatic ducts. Endoscopic insertion of a biliary stent managed to prevent jaundice and recurrent pancreatitis.

Published
1990

21. Reconstruction of a 4D heart from CT images

Author

E. Libson, Alexander Yakhot, Tomer Anor, George Em Karniadakis, and J. Sosna

Subjects
business.industry, Rotational angiography, Rehabilitation, Biomedical Engineering, Biophysics, Medicine, Orthopedics and Sports Medicine, business, Nuclear medicine
Published
2006
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23. Scoliosis in Young Men With Spondylolysis or Spondylolisthesis

Author

E Libson, R A Bloom, and Y Shapiro

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Idiopathic scoliosis, Spondylolysis, Scoliosis, Lumbar vertebrae, Asymptomatic, medicine, Humans, Orthopedics and Sports Medicine, Lumbar Vertebrae, business.industry, Incidence (epidemiology), medicine.disease, Spondylolisthesis, Surgery, medicine.anatomical_structure, Neurology (clinical), medicine.symptom, business, muscle spasm
Abstract

While an increased incidence of scoliosis in symptomatic spondylolysis and spondylolisthesis has been established previously, a comparison of its occurrence in symptomatic and asymptomatic individuals has not been performed. The present study is a comparison of symptomatic and asymptomatic young men with analysis as to the incidence of scoliosis. Idiopathic scoliosis was not found and all cases were due to spasm scoliosis or olisthetic scoliosis with the spasm type being much more common. Scoliotic curves were divided into mild (0-9 degrees) and moderate (10-20 degrees). No case of a curve greater than 20 degrees was seen. Scoliosis incidence in asymptomatic individuals without a pars break was 6.65%. In the groups of: (1) asymptomatic unilateral spondylolysis, (2) asymptomatic bilateral spondylolysis, (3) symptomatic bilateral spondylolysis, and (4) asymptomatic spondylolisthesis the scoliosis incidence was similar, ranging from 13.3-23.8%. These figures are significantly higher than those seen in the asymptomatic subjects without a pars break, but they are in the same range as in symptomatic patients without a pars break, suggesting that muscle spasm is the principal cause of the scoliosis.

Published
1984
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24. Intussusception in intestinal lymphoma: the role of colonoscopy

Author

E. Goldin and E. Libson

Subjects
Male, medicine.medical_specialty, Ileocecal Valve, medicine.diagnostic_test, Lymphoma, business.industry, General surgery, Colonoscopy, General Medicine, medicine.disease, Intestinal lymphoma, Surgery, Ileocecal valve, medicine.anatomical_structure, Intussusception (medical disorder), Colonic Neoplasms, medicine, Humans, business, Complication, Child, Intussusception, Research Article
Abstract

Summary Intussusception is a well known complication and sometimes the presenting symptom of intestinal lymphoma. The final diagnosis in most patients is made by surgery. We report a 12 year old boy with intussusception in whom the diagnosis was established by colonoscopy and surgery was avoided.

Published
1986

25. Bilateral symmetrical clavicular periosteal reactions in a child

Author

L, Haskell, R A, Bloom, M, Rottem, A, Boneh, and E, Libson

Subjects
Diagnosis, Differential, Male, Radiography, Periostitis, Humans, Osteomyelitis, Subacute Sclerosing Panencephalitis, Child, Clavicle
Abstract

A case of bilateral symmetrical periosteal reactions of the lateral halves of the clavicles in a child with subacute sclerosing panencephalitis is presented. The appearances correspond with no previously recorded condition. The differential diagnosis most likely lies between aborted Salmonella osteomyelitis or a form fruste of subacute symmetrical osteomyelitis.

Published
1984

26. Crohn's disease of the duodenum presented as pancreatitis due to persimmon bezoar

Author

Alexander Fich, E Katz, Daniel Rachmilewitz, E. Libson, and R Eliakim

Subjects
Male, medicine.medical_specialty, Ampulla of Vater, Duodenum, Gastroenterology, Bezoars, Duodenitis, Crohn Disease, Internal medicine, medicine, Humans, Pancreatic duct, Crohn's disease, business.industry, digestive, oral, and skin physiology, Middle Aged, medicine.disease, digestive system diseases, medicine.anatomical_structure, Pancreatitis, Fruit, Phytobezoar, Acute Disease, Bezoar, business
Abstract

Pancreatitis due to Crohn's disease of the duodenum is very rare. It is the result of either reflux of duodenal content into the pancreatic duct or stenosis due to direct involvement of the ampullary region with Crohn's disease. The patient described had isolated Crohn's disease of the duodenum; pancreatitis was the result of persimmon bezoar's constricting the ampullary region.

Published
1987

27. Symptomatic and asymptomatic spondylolysis and spondylolisthesis in young adults

Author

R. A. Bloom, E. Libson, and G. Dinari

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Spondylolysis, Asymptomatic, medicine, Humans, Orthopedics and Sports Medicine, Young adult, Israel, Military Medicine, Retrospective Studies, Lumbar Vertebrae, business.industry, Incidence (epidemiology), medicine.disease, Low back pain, Spondylolisthesis, Surgery, Radiography, Back Pain, Orthopedic surgery, Lumbar spine, medicine.symptom, business
Abstract

The lumbar spine was examined radiologically for the presence of spondylolysis and spondylolisthesis in 936 asymptomatic soldiers prior to military placement and in 662 soldiers complaining of low back pain. The overall incidence of spondylolysis was 9.7% in both groups, but bilateral spondylolysis was more prone to be associated with symptoms than a unilateral defect. In the symptomatic group the incidence of spondylolisthesis was 5.3% but only 2.2% in the asymptomatic group. The defect was seen in the oblique views only in 18.7% of the cases of spondylolysis. The precise diagnosis is important for vocational counselling and military placement.

Published
1982

28. Anteroposterior angulated view. A new radiographic technique for the evaluation of spondylolysis

Author

R A Bloom and E Libson

Subjects
Adult, Male, Lumbar Vertebrae, Adolescent, business.industry, Radiography, Bony union, Posture, Spondylolysis, Anatomy, medicine.disease, Pars interarticularis, medicine, Humans, Radiology, Nuclear Medicine and imaging, Lumbar spine, Spondylolisthesis, business
Abstract

A 30 degrees cranial angulated view for the evaluation of spondylolysis demonstrates the pars interarticularis with minimal distortion and without being obscured by overlying bony structures. The degree of callous formation and bony union can be assessed.

Published
1983

30. Diffuse large cell non-Hodgkin's lymphoma: results of M-BACOD combination chemotherapy

Author

A, Polliack, B, Uziely, R, Isacson, G, Lugassy, S, Rochlemer, E, Gez, E, Libson, A, Sulkes, and Z, Weshler

Subjects
Adult, Aged, 80 and over, Male, Adolescent, Leucovorin, Middle Aged, Combined Modality Therapy, Transplantation, Autologous, Dexamethasone, Bleomycin, Methotrexate, Doxorubicin, Vincristine, Antineoplastic Combined Chemotherapy Protocols, Humans, Female, Lymphoma, Large B-Cell, Diffuse, Cyclophosphamide, Aged, Bone Marrow Transplantation
Abstract

Twenty-seven adult patients with diffuse large cell lymphoma were treated with the M-BACOD regimen during the period 1980-86. Of these, 24 (89%) had advanced Stage III-IV disease by clinical staging and only 3 (11%) had limited disease. CR was achieved in 14 patients (52%), all of whom had advanced disease prior to therapy. The remaining 13 patients (48%) achieved only PR. Of the entire group of 27 patients, 11 (41%) died, 12 (44%) are still in CR, and 4 (15%) have relapsed and are still alive with PR. Of the 14 patients who achieved CR, 1 relapsed, but is currently in PR, showing minimal disease. All of these 14 patients are alive (11 months to 6 years post therapy), and 13 (93%) still remain in CR with a median time of CR of 45 months. Of the 13 patients who only achieved PR, 11 (85%) relapsed and died within a median time of 3.6 months, and 2 patients remain in PR. The above results are similar to those obtained in larger series recorded from other centers. In the light of improved results obtained with new regimens and ABMT, we have now adopted the MACOP-B regimen for treating aggressive lymphoma and have entered an ABMT program for patients with predictable poor prognostic features.

Published
1988

31. Burkitt's lymphoma in an old patient with diarrhea: ileoscopic diagnosis

Author

D, Wengrower, E, Goldin, E, Libson, and E, Okon

Subjects
Diarrhea, Ileal Neoplasms, Male, Age Factors, Humans, Endoscopy, Middle Aged, Burkitt Lymphoma
Abstract

A 61-yr-old man with Burkitt's lymphoma who presented with 6 months of diarrhea was found, at ileoscopy, to have inflammation of the mucosal narrow lumen, deep linear ulcerations, and a "cobblestone" appearance of the terminal ileum. Endoscopic biopsies were diagnostic of Burkitt's lymphoma, and no laparotomy was necessary. Presentation with diarrhea and the age of the patient were unusual, and the endoscopic features and diagnosis of the disease in the terminal ileum made by ileoscopy have not been previously reported.

Published
1988

33. Plasmacytoma of the breast. Unusual initial presentation of myeloma: report of two cases and review of the literature

Author

Aaron Polliack, A. Ben-Yehuda, E. Libson, and D. Steiner-Saltz

Subjects
Breast biopsy, medicine.medical_specialty, Mammary gland, Breast Neoplasms, Diagnosis, Differential, immune system diseases, hemic and lymphatic diseases, Internal medicine, Immunopathology, medicine, Humans, skin and connective tissue diseases, Multiple myeloma, Plasma cell leukemia, Hematology, medicine.diagnostic_test, business.industry, Amyloidosis, General Medicine, Middle Aged, medicine.disease, medicine.anatomical_structure, Plasmacytoma, Female, Radiology, business, Multiple Myeloma
Abstract

Two patients who presented initially with breast masses proven to be plasmacytomas, are described. In both cases the breast masses led to the diagnosis of multiple myeloma, which was retrospectively already present at the time of the breast biopsy. One patient with IgG lambda-type myeloma developed plasma cell leukemia and amyloidosis and failed to respond to radiochemotherapy. The second patient was in complete remission, four years after therapy, but has subsequently relapsed and died. All cases of breast plasmacytoma, described in the medical literatures are reviewed, and guidelines for future therapy are suggested.

Published
1989

34. Endoscopic insertion of endoprostheses in the treatment of postoperative cutaneous biliary fistula

Author

E, Goldin, E, Libson, and D, Rachmilewitz

Subjects
Male, Biliary Fistula, Postoperative Complications, Drainage, Humans, Endoscopy, Prostheses and Implants, Middle Aged, Skin
Abstract

We report a case in which a large, postoperative, biliary cutaneous fistula was successfully treated by means of endoscopic insertion of two endoprostheses into the common bile duct. Twenty-four hours after the procedure, bile flow from the cutaneous fistula ceased completely. The endoprostheses were removed after 6 weeks, and no evidence of leak from the biliary tract was seen on a retrograde cholangiogram. For the treatment of postoperative biliary leaks, insertion of endoprostheses is a good and safe alternative to surgery.

Published
1987

35. Giant duodenal ulcer: the hepatic intra-arterial chemotherapy variant

Author

E. Goldin, E. Libson, and T. Peretz

Subjects
Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, Intra arterial chemotherapy, Disease, Gastroenterology, Hepatic Artery, Internal medicine, Duodenal bulb, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Infusions, Intra-Arterial, Aged, Chemotherapy, business.industry, Mortality rate, Liver Neoplasms, General Medicine, Middle Aged, medicine.disease, Zollinger-Ellison syndrome, digestive system diseases, medicine.anatomical_structure, Hepatocellular carcinoma, Duodenal Ulcer, Etiology, Female, business, Research Article
Abstract

Summary Giant duodenal ulcers are extensive ulcers, more than 2.5 cm in diameter, that involve a large portion of the duodenal bulb. These atypical duodenal ulcers create serious problems to the patient and the physician, are frequently complicated by bleeding and penetration, and have a high mortality rate. Most of the reported cases were classified as a severe variant of the common peptic ulcer disease, others were associated with the Zollinger Ellison syndrome. We report here four patients with giant duodenal ulcers but with a different and definitive aetiology: hepatic intra-arterial chemotherapy infusion for liver metastase or primary hepatocellular carcinoma.

Published
1988

36. Second Chance for Cure: Stereotactic Ablative Radiotherapy in Oligometastatic Disease.

Author

Salim N, Tumanova K, Popodko A, and Libson E

Subjects
Humans, Male, Female, Retrospective Studies, Aged, Middle Aged, Aged, 80 and over, Adult, Neoplasms pathology, Neoplasms radiotherapy, Neoplasms mortality, Progression-Free Survival, Radiosurgery methods, Neoplasm Metastasis radiotherapy
Abstract

Purpose: Local ablative therapy, such as radiotherapy or surgery, plays a key role in treatment of patients with oligometastatic disease. Stereotactic ablative body radiotherapy (SABR) comes to the fore as a safe and effective treatment for patients with a limited number of metastases, even those located in hard-to-reach body sites. Many researchers have suggested that metastatsis-directed therapy could improve long-term progression-free survival (PFS) and overall survival (OS) in patients with oligometastases., Patients and Methods: This was a retrospective, single-arm, observational study conducted between July 2015 and February 2022. In our institute, 60 patients with controlled primary tumors and one to five metastases were treated with SABR. Prescribed radiation doses ranged from 12 to 60 Gy administered in one to seven fractions. We aimed to determine whether metastatic-directed therapy using SABR for all oligometastases affects OS and PFS and whether the primary tumor or metastatic site influences OS/PFS., Results: The most common primary malignancy types were prostate (n = 14), colorectal (n = 10), lung (n = 7), and breast cancers (n = 6). The median follow-up was 30 months, ranging from 9 to 79. The 1-, 3-, and 5-year PFS and OS rates were 54.9%, 37.0%, and 37.0% and 98.3%, 84.4%, and 73.8%, respectively, and the median time to first progression was 15 (range, 2-32) months. Twenty-four (40%) patients had no recurrence. In our analysis, primary tumor site was not an independent prognostic factor. The metastatic site may influence on patient outcome in cases of localized bone and liver metastases., Conclusion: In our retrospective analysis, SABR was associated with favorable levels of PFS and OS in patients with oligometastases. The limitations of our study were lacking high-level evidence, and randomized studies to compare SABR and palliative standard of care are mandatory.

Published
2024
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37. Stereotactic radiosurgery as a successful method to control meningeal metastatic adenoid cystic carcinoma of the lacrimal gland: A case report.

Author

Salim N, Libson E, Tumanova K, and Krotenkova I

Abstract

Adenoid cystic carcinoma (ACC) of the lacrimal gland is a rare tumor. In addition, considering the lack of data on large groups of patients there is no standard of care to treat patients with multiple meningeal metastases of ACC. A two-year analysis of the course of the disease in a patient with synchronous oligometastatic ACC of the lacrimal gland that was treated with stereotactic radiosurgery (SRS) is presented. The aim of the present case report was to evaluate the effect of SRS in the treatment of a patient with ACC. Preliminary results confirmed that this method was highly effective in this patient. The patient is currently living with a good quality of life, normal vision and with no evidence of disease or complications. SRS exhibited reliable local tumor control and insignificant radiation-related complications, rendering it an encouraging treatment option for patients with recurrent or metastatic ACC., Competing Interests: The authors have no relevant financial or non-financial interests to disclose., (Copyright: © Salim et al.)

Published
2022
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38. Radiology department, human factors and organizational perspectives: using action research to improve patient safety.

Author

Tourgeman-Bashkin O, Shinar D, Donchin Y, Zmora E, Velleman N, and Libson E

Abstract

Background: Action research is a participatory research method based on active cooperation between researchers and subjects. In clinical practice, action research enables active involvement of workers in developing and implementing actions promoting patient safety. This article describes a participatory action research project that was conducted in the radiology department of a tertiary care university hospital. The main objectives were: identifying potential adverse events in the department of radiology, and offering a proactive approach to improving patient safety., Methods: Phase one of the study included observing 100 patients in three units of the department and identifying potential adverse events using an observation form. According to the data obtained from the observations, multidisciplinary research teams developed and initiated, together with front-line workers, four types of interventions: ergonomic interventions in work environment design, interventions in work procedure and task design, training and guidance, and managerial interventions. Phase two included evaluation of the interventions after six months of implementation., Results: Results showed different weaknesses in each of the three radiology units tested, including incomplete medical information necessary for performing the radiological procedure, and discontinuity of care. Post-intervention observations showed a significant reduction in the prevalence of potential adverse events. At the Angiography unit, potential adverse events related to incomplete medical information dropped from 50% to 32%, and at the CT unit they dropped from 70% to 23%. At the MRI unit potential adverse events related to discontinuity of care dropped from 61% to 19%., Conclusions: The current study demonstrates the value of action research in non-hospitalizing health units and the benefits of cooperation between medical teams and human factor professionals in promoting patient safety. Methods similar to those described in the current paper are applicable to medical work teams in a broad range of practices.

Published
2013
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39. JOURNAL CLUB: Is screening MRI indicated for women with a personal history of breast cancer? Analysis based on biopsy results.

Author

Arazi-Kleinman T, Skair-Levy M, Slonimsky E, Maly B, Uziely B, Libson E, and Sella T

Subjects
Adult, Aged, Breast Neoplasms prevention & control, Female, Humans, Incidence, Israel epidemiology, Middle Aged, Prevalence, Prognosis, Reproducibility of Results, Risk Assessment, Sensitivity and Specificity, Breast Neoplasms diagnosis, Breast Neoplasms epidemiology, Image-Guided Biopsy statistics & numerical data, Magnetic Resonance Imaging statistics & numerical data, Mass Screening statistics & numerical data
Abstract

Objective: American College of Radiology and Society of Breast Imaging guidelines call for routine breast MRI screening only for women with the highest risk profiles for development of breast cancer, suggesting that screening of women at lower risk might result in an increased frequency of false-positive biopsy results. The purpose of this study was to test this assumption by comparing MRI-guided biopsy outcomes of lesions detected at MRI screening of women with a personal history of breast cancer with outcomes among women with genetic or familial high risk., Materials and Methods: Outcomes of 130 MRI-guided biopsies were analyzed. One group consisted of women with hereditary (genetic or familial) risk, and the other group consisted of women with a personal history of breast cancer. Biopsies were performed with a 9-gauge vacuum-assisted device or surgically after MRI localization., Results: Of 130 MRI-guided biopsies, 20 (15%) yielded malignant histologic findings, 14 (11%) yielded high-risk lesions, and 96 (74%) had benign findings. There was a slightly higher malignancy rate for the personal-risk group (19%) compared with the hereditary-risk group (13.5%). There also was a slightly higher combined rate of malignancy and high-risk lesions (34% vs 22%) with no statistically significant difference (p < 0.25, p < 0.12). Patients in the hereditary-risk group were younger (44 ± 1.2 vs 54 ± 1.7 years; p < 0.001) than those in the personal-risk group., Conclusion: Our preliminary data show no difference between the two risk groups with respect to probability of an MRI-guided biopsy result of malignancy, calling into question the proposed assumption. Further prospective studies of the role of MRI screening combined with MRI-guided biopsy when required for patients with previously treated localized breast cancer may be indicated.

Published
2013
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40. A novel functional infrared imaging system coupled with multiparametric computerised analysis for risk assessment of breast cancer.

Author

Sella T, Sklair-Levy M, Cohen M, Rozin M, Shapiro-Feinberg M, Allweis TM, Libson E, and Izhaky D

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Infrared Rays, Israel epidemiology, Middle Aged, Prevalence, Prospective Studies, Reproducibility of Results, Risk Assessment, Sensitivity and Specificity, Single-Blind Method, Thermography methods, Young Adult, Breast Neoplasms diagnosis, Breast Neoplasms epidemiology, Imaging, Three-Dimensional instrumentation, Imaging, Three-Dimensional statistics & numerical data, Proportional Hazards Models, Thermography instrumentation, Thermography statistics & numerical data
Abstract

Objective: We evaluated a functional three-dimensional (3D) infrared imaging system (3DIRI) coupled with multiparametric computer analysis for risk assessment of breast cancer. The technique provides objective risk assessment for the presence of a malignant tumour based on automated parameters derived from a clinically known training set., Methods: Following institutional review board approval, we recruited 434 women for this prospective multicentre trial, including 256 healthy woman undergoing routine screening mammography with BI-RADS-1 results and 178 women with newly diagnosed breast cancer. This was a two-phase study: an initial training and calibration phase, followed by a two-armed blinded evaluation phase (52 healthy and 66 with breast cancer). 3DIRI data sets were acquired using a non-contact, no radiation system., Results: The sensitivity and specificity of functional infrared imaging in providing the correct risk for the presence of breast cancer were 90.9 % and 72.5 %, respectively. The area under the ROC curve was 86 %. Forty-two of the 60 (70 %) cancers in women correctly classified by the system as suspicious were smaller than 20 mm in size., Conclusion: The preliminary blinded results of this novel technology show sufficient performance of functional infrared imaging in providing risk assessment for breast cancer to warrant further clinical studies., Key Points: • 3D functional infrared imaging (3DIRI) provides new metabolic signatures from breast lesions. • 3DIRI offers high sensitivity for risk assessment of breast cancer. • It also has reasonable specificity. • This initial experience warrants further evaluation in larger clinical trials.

Published
2013
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41. Algorithm optimization for multitined radiofrequency ablation: comparative study in ex vivo and in vivo bovine liver.

Author

Appelbaum L, Sosna J, Pearson R, Perez S, Nissenbaum Y, Mertyna P, Libson E, and Goldberg SN

Subjects
Analysis of Variance, Animals, Catheter Ablation instrumentation, Cattle, Electrodes, Models, Animal, Prospective Studies, Algorithms, Catheter Ablation methods, Liver surgery
Abstract

Purpose: To prospectively optimize multistep algorithms for largest available multitined radiofrequency (RF) electrode system in ex vivo and in vivo tissues, to determine best energy parameters to achieve large predictable target sizes of coagulation, and to compare these algorithms with manufacturer's recommended algorithms., Materials and Methods: Institutional animal care and use committee approval was obtained for the in vivo portion of this study. Ablation (n = 473) was performed in ex vivo bovine liver; final tine extension was 5-7 cm. Variables in stepped-deployment RF algorithm were interrogated and included initial current ramping to 105 degrees C (1 degrees C/0.5-5.0 sec), the number of sequential tine extensions (2-7 cm), and duration of application (4-12 minutes) for final two to three tine extensions. Optimal parameters to achieve 5-7 cm of coagulation were compared with recommended algorithms. Optimal settings for 5- and 6-cm final tine extensions were confirmed in in vivo perfused bovine liver (n = 14). Multivariate analysis of variance and/or paired t tests were used., Results: Mean RF ablation zones of 5.1 cm +/- 0.2 (standard deviation), 6.3 cm +/- 0.4, and 7 cm +/- 0.3 were achieved with 5-, 6-, and 7-cm final tine extensions in a mean of 19.5 min +/- 0.5, 27.9 min +/- 6, and 37.1 min +/- 2.3, respectively, at optimal settings. With these algorithms, size of ablation at 6- and 7-cm tine extension significantly increased from mean of 5.4 cm +/- 0.4 and 6.1 cm +/- 0.6 (manufacturer's algorithms) (P <.05, both comparisons); two recommended tine extensions were eliminated. In vivo confirmation produced mean diameter in specified time: 5.5 cm +/- 0.4 in 18.5 min +/- 0.5 (5-cm extensions) and 5.7 cm +/- 0.2 in 21.2 min +/- 0.6 (6-cm extensions)., Conclusion: Large zones of coagulation of 5-7 cm can be created with optimized RF algorithms that help reduce number of tine extensions compared with manufacturer's recommendations. Such algorithms are likely to facilitate the utility of these devices for RF ablation of focal tumors in clinical practice., ((c) RSNA, 2010.)

Published
2010
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42. Magnetic resonance-guided interventional procedures of the breast: initial experience.

Author

Eliahou R, Sella T, Allweis T, Samet Y, Libson E, and Sklair-Levy M

Subjects
Adult, Aged, Biopsy, Needle methods, Breast Diseases diagnosis, Breast Diseases diagnostic imaging, Breast Diseases pathology, Breast Neoplasms diagnostic imaging, Breast Neoplasms pathology, Female, Gadolinium, Humans, Middle Aged, Radiography, Retrospective Studies, Ultrasonography, Breast pathology, Breast Neoplasms diagnosis, Magnetic Resonance Imaging
Abstract

Background: Magnetic resonance imaging of the breast has emerged as a valuable imaging tool in addition to conventional imaging modalities. It has high sensitivity for malignant lesions and can detect mammographically, sonographically and clinically occult cancers. "MR only" lesions are best biopsied under MR guidance; however, this may be a challenging task., Objectives: To evaluate our initial clinical experience with MR-guided core needle breast biopsy and MR-guided needle localization., Methods: We retrospectively evaluated 81 women with 97 lesions, who were scheduled for guided core needle biopsy or MR-guided needle localization followed by surgery. Lesions were categorized as malignant, high risk, or benign according to the BI-RADS MR classification system. MR findings were compared with final histopathology or with follow-up imaging findings., Results: Fifteen (16%) lesions were malignant (9 invasive ductal carcinoma, 2 invasive lobular carcinoma, 4 ductal carcinoma in situ); 7 (7%) lesions were high risk (4 atypical ductal hyperplasia, 3 radial scars); 75 (77%) lesions were benign, mainly fibrocystic changes. Other benign findings were sclerosing adenosis, pseudoangiomatous stromal hyperplasia, fat necrosis, intraductal papilloma, fibroadenoma, capillary hemangioma, and florid ductal hyperplasia. No major complications were encountered., Conclusions: MR-guided interventional procedures of the breast are accurate, safe and feasible methods for sampling breast lesions detected only by MR and have become a significant tool in the management of certain patients.

Published
2009

44. CT colonography: positioning order and intracolonic pressure.

Author

Sosna J, Bar-Ziv J, Libson E, Eligulashvili M, and Blachar A

Subjects
Abdominal Pain diagnostic imaging, Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Colon physiology, Female, Humans, Imaging, Three-Dimensional, Insufflation methods, Logistic Models, Male, Middle Aged, Pressure, Prospective Studies, Rectum physiology, Colonography, Computed Tomographic methods, Prone Position physiology, Supine Position physiology
Abstract

Objective: The purpose of this study was to prospectively evaluate the effect of the order of positions on sustained rectal pressure and factors affecting pain perceived by patients during air-insufflated CT colonography., Subjects and Methods: Rectal pressure was measured in the supine and prone positions for CT colonography of 379 patients in two groups. One hundred seventy-seven patients underwent imaging supine and then prone, and 202 patients were prone and then supine. Insufflation and patient pain parameters were based on patient self-report and investigator visualization of observable indicators. Colonic distention, residual feces or fluid, and diverticulosis were evaluated with a semiquantitative scoring system. Fisher's exact, Student's t, and chi-square tests as well as multivariate logistic regression analysis were performed., Results: Pressure was higher in the prone than in the supine position in both groups (p < 0.001). The measured pressure in the initial position did not differ between groups (p = 0.88). Pressure increased from 38.3 to 40.07 mm Hg in the second position in the supine-first group and decreased from 38.3 to 32.25 mm Hg in the second position in the prone-first group (p < 0.001). The percentage of patients with pain in the second position was 40% in the supine-first group compared with 18% in the prone-first group (p < 0.003). Distention did not differ between the groups. Pain was associated with increased pressure and diverticulosis (p < 0.001) but not with retained feces or fluid., Conclusion: Sustained pressure in the air-insufflated colon was higher in the prone than in the supine position. Imaging in the prone position first results in a significant decrease in pressure in the latter phase and less pain. Pain was associated with pressure and diverticulosis.

Published
2008
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45. Critical analysis of the performance of double-contrast barium enema for detecting colorectal polyps > or = 6 mm in the era of CT colonography.

Author

Sosna J, Sella T, Sy O, Lavin PT, Eliahou R, Fraifeld S, and Libson E

Subjects
Enema, Female, Humans, Intestinal Polyps diagnostic imaging, Intestinal Polyps epidemiology, Male, Prevalence, Reproducibility of Results, Sensitivity and Specificity, Barium Sulfate administration & dosage, Colonic Polyps diagnostic imaging, Colonic Polyps epidemiology, Colonography, Computed Tomographic statistics & numerical data
Abstract

Objective: The purpose of our study was to perform a meta-analysis comparing the performance of double-contrast barium enema (DCBE) with CT colonography (CTC) for the detection of colorectal polyps > or = 6 mm using endoscopy as the gold standard., Materials and Methods: Prospective DCBE and CTC studies were identified. Percentages of polyps and of patients with polyps > or = 10 mm and 6-9 mm were abstracted. The performance of DCBE versus CTC was determined by separately evaluating each technique's performance versus that of endoscopy, and contrasting the techniques. The I-squared statistic and Fisher's exact test were used for heterogeneity, the Cochran-Mantel-Haenszel and the Kruskal-Wallis tests for correlation, and the A(z) test for comparing pooled weighted estimates of performance., Results: Eleven studies of DCBE (5,995 patients, 1,548 polyps) and 30 studies of CTC (6,573 patients, 2,348 polyps) fulfilled inclusion criteria. For polyps > or = 10 mm, a 0.121-per-patient sensitivity difference favored CTC (p < 0.0001; DCBE, 0.702 [95% CI, 0.687-0.715]; CTC, 0.823 [0.809-0.836]). For polyps > or = 10 mm, a 0.031-per-polyp sensitivity difference favored CTC (p < 0.0001; DCBE, 0.715 [0.703-0.726]; CTC, 0.746 [0.735-0.757]). For polyps > or = 10 mm, a specificity difference of 0.104 favored CTC (p = 0.001; DCBE, 0.850 [0.847-0.855]; CTC, 0.954 [0.952-0.955]). DCBE was also significantly less sensitive for 6- to 9-mm polyps (p < 0.001)., Conclusion: DCBE has statistically lower sensitivity and specificity than CTC for detecting colorectal polyps > or = 6 mm.

Published
2008
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46. Incidence and management of complex fibroadenomas.

Author

Sklair-Levy M, Sella T, Alweiss T, Craciun I, Libson E, and Mally B

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, Breast Neoplasms pathology, Breast Neoplasms therapy, Child, Female, Fibroadenoma pathology, Fibroadenoma therapy, Humans, Incidence, Male, Mammography, Middle Aged, Breast Neoplasms diagnosis, Breast Neoplasms epidemiology, Fibroadenoma diagnosis, Fibroadenoma epidemiology
Abstract

Objective: Complex fibroadenomas are a fibroadenoma subtype harboring one or more complex features. We sought to evaluate the incidence of complex fibroadenoma on biopsy and to propose decision criteria for managing patients with these breast lesions., Materials and Methods: Complex fibroadenomas were diagnosed in 63 of 401 fibroadenomas (15.7%) found at consecutive percutaneous needle or excisional surgical biopsy. We evaluated the clinical and imaging presentations of complex fibroadenomas; compared pathology at core and excisional biopsy; and contrasted age, pathology, and size of complex and simple fibroadenomas using the Student's t test., Results: Patients with complex lesions were 18.5 years older (median age, 47 years; range, 21-69 years) than patients with noncomplex fibroadenomas (median age, 28.5 years; range, 12-86 years) (p < 0.001). Complex fibroadenomas were half the size (average, 1.3 cm; range, 0.5-2.6 cm) of noncomplex fibroadenomas (average, 2.5 cm; range, 0.5-7.5 cm) (p < 0.001). Only one malignancy, an invasive lobular carcinoma, was found in 63 complex fibroadenomas (1.6%). This patient had atypical lobular hyperplasia at core needle biopsy., Conclusion: Approximately 16% of fibroadenomas are complex. Complex fibroadenomas are smaller and appear at an older age. At a mean follow-up of 2 years, we found a low incidence of malignancy in complex fibroadenomas. Women with complex fibroadenomas may therefore be managed with a conservative approach, similar to the approach now recommended for women with simple fibroadenomas.

Published
2008
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47. Percutaneous image-guided splenic procedures: update on indications, technique, complications, and outcomes.

Author

Lieberman S, Libson E, Sella T, Lebensart P, and Sosna J

Subjects
Biopsy, Needle methods, Drainage methods, Humans, Suction methods, Tomography, X-Ray Computed, Radiography, Interventional, Splenic Diseases pathology, Splenic Diseases therapy, Ultrasonography, Interventional
Abstract

Percutaneous image-guided splenic procedures are seldom performed due to fear of complications, mainly hemorrhage. Percutaneous splenic invasive procedures are, however, safe, and in most cases, the complication rates are similar to those of other abdominal organs. In most patients, biopsy of a focal splenic lesion establishes the diagnosis. Aspiration and drainage of splenic collections are performed obviating the need for splenectomy. In this review we describe the indications, technique, complications, and outcomes of percutaneous splenic biopsy, aspiration, and drainage.

Published
2007
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48. Contribution of 11C-choline positron emission tomography/computerized tomography to preoperative staging of advanced transitional cell carcinoma.

Author

Gofrit ON, Mishani E, Orevi M, Klein M, Freedman N, Pode D, Shapiro A, Katz R, Libson E, and Chisin R

Subjects
Aged, Aged, 80 and over, Carcinoma, Transitional Cell pathology, Disease Progression, Female, Humans, Male, Neoplasm Staging, Preoperative Care, Prospective Studies, Urinary Bladder Neoplasms pathology, Carbon Radioisotopes, Carcinoma, Transitional Cell diagnostic imaging, Choline, Positron-Emission Tomography, Tomography, X-Ray Computed, Urinary Bladder Neoplasms diagnostic imaging
Abstract

Purpose: Current imaging modalities for preoperative staging of advanced transitional cell carcinoma of the bladder or upper urinary tract are not sensitive for detection of metastases. This study examines the contribution of 11C-choline positron emission tomography/computerized tomography to preoperative staging of transitional cell carcinoma., Materials and Methods: We prospectively evaluated 18 patients with 19 advanced transitional cell carcinomas (17 bladder tumors and 2 upper tract transitional cell carcinomas). All patients had computerized tomography of the chest, abdomen and pelvis negative for metastases. 11C-choline positron emission tomography/computerized tomography was performed on a Discovery ST(R) positron emission tomography/computerized tomography system. Finally 16 patients underwent radical surgery and positron emission tomography/computerized tomography images were compared to histopathological findings. Two patients were not operated on due to the findings on 11C-choline positron emission tomography/computerized tomography., Results: 11C-choline uptake was found in all primary transitional cell carcinomas, with a maximum standardized uptake value of 7.3 +/- 3.2 (mean +/- SD). The series included 3 patients with refractory bladder carcinoma in situ, which was visualized in all 3, with a standardized uptake value of 6.9 +/- 5.6. In 6 patients uptake of 11C-choline in lymph nodes as small as 5 mm was visualized (standardized uptake value 3.8 +/- 1.4). Of these patients 4 underwent surgery and histopathology confirmed malignancy in 3 of 4. No additional patients with positive lymph nodes were found on histopathology. Metastases were visualized in bones with normal architecture on computerized tomography in 4 patients (standardized uptake value 5.2 +/- 1.1) and were confirmed by followup computerized tomography., Conclusions: In this small series 11C-choline positron emission tomography/computerized tomography was highly sensitive for primary and metastatic transitional cell carcinoma. Carcinoma in situ, lymph node metastases and early bony metastases were visualized. 11C-choline positron emission tomography/computerized tomography is a promising tool for preoperative staging of advanced transitional cell carcinoma.

Published
2006
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49. CT pulmonary angiography for the detection of pulmonary embolism: interobserver agreement between on-call radiology residents and specialists (CTPA interobserver agreement).

Author

Shaham D, Heffez R, Bogot NR, Libson E, and Brezis M

Subjects
Angiography statistics & numerical data, Humans, Israel epidemiology, Observer Variation, Pulmonary Embolism epidemiology, Reproducibility of Results, Sensitivity and Specificity, Tomography, X-Ray Computed statistics & numerical data, Angiography methods, Internship and Residency, Pulmonary Artery diagnostic imaging, Pulmonary Embolism diagnostic imaging, Radiology, Tomography, X-Ray Computed methods
Abstract

Purpose: The aim of this study was to prospectively determine interobserver agreement between on-call radiology residents and specialists in the interpretation of computed tomographic pulmonary angiography (CTPA)., Methods: CTPA examinations obtained between January 2002 and March 2003 were interpreted by a radiology resident on call and by two radiology specialists. Agreement was assessed using percentage of agreement between interpreters and by the kappa coefficient. Sensitivity of residents' interpretations was calculated by relating them to the interpretation of Specialist 1, which served as the gold standard., Results: Of the 81 CTPA examinations evaluated, there was agreement of 93% and 91% for the diagnosis of pulmonary embolism (PE) and of 97% and 85% for the exclusion of PE with Specialist 1 and 2, respectively. The concordance between residents' interpretations and those of Specialist 1 was very high (kappa=.8), and with those of Specialist 2 was high (kappa=.7). In all cases of agreement between the two specialists, there was complete agreement between the specialists' and the residents' intepretations., Conclusions: Our study showed good to very good agreement of residents' interpretations with each of the radiology specialists. Therefore, relying on the residents' preliminary interpretations during after-hour calls is reasonable.

Published
2006
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50. Perforation of the colon and rectum--a newly recognized complication of CT colonography.

Author

Sosna J, Sella T, Bar-Ziv J, and Libson E

Subjects
Barium Sulfate, Contrast Media, Enema adverse effects, Humans, Risk Factors, Colon injuries, Colonography, Computed Tomographic adverse effects, Rectum injuries
Abstract

CT colonography (CTC) and conventional colonoscopy may have similar efficacy for detection of polyps > 6 mm. Perforation of the colon and rectum is a relatively rare, but potentially morbid complication of CTC, especially in symptomatic patients. Older age and underlying concomitant colon pathology increase the risk of perforation. This review describes the incidence, clinical features, and management of colon perforations at CTC, a study that was considered risk-free until recently.

Published
2006
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